Provider Demographics
NPI:1457305807
Name:REDDY AND ASSOCIATES PC
Entity Type:Organization
Organization Name:REDDY AND ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECTS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHALIMAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-728-3921
Mailing Address - Street 1:PO BOX 57155
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-7155
Mailing Address - Country:US
Mailing Address - Phone:215-725-7600
Mailing Address - Fax:215-725-7700
Practice Address - Street 1:7600 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2442
Practice Address - Country:US
Practice Address - Phone:215-725-7600
Practice Address - Fax:215-725-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA615171Medicare PIN